Kapadiya Dixitkumar Jayantibhai, Dave Paresh V, Vadera Bhavin, Patel Pranav Govindbhai, Chawla Sudhir, Saxena Deepak
State TB Training and Demonstration Center, Ahmedabad, Gujarat, India.
Department of Health and Family Welfare, Government of Gujarat, Gandhinagar, Gujarat, India.
Indian J Community Med. 2018 Jul-Sep;43(3):185-189. doi: 10.4103/ijcm.IJCM_291_17.
Tuberculosis (TB) is first opportunistic infection and leading cause of death among human immunodeficiency virus (HIV)/AIDS. Certainly, the prevalence of TB is expected to differ between general population and HIV-infected persons. This study was conducted to determine the prevalence of TB among newly diagnosed HIV-infected adults attending antiretroviral therapy (ART) center in the state of Gujarat, India.
Cross-sectional study was carried out among newly diagnosed HIV-infected persons attending ART center from July 2012 to September 2012. Screening of TB symptoms and chest X-ray was done for those who consented. Sputum samples were collected for microscopy with Ziehl-Neelsen method for all presumptive TB cases and those diagnosed as pulmonary TB, culture, and drug susceptibility test was done. Blood samples were collected for CD4+ T-cells count and hemoglobin.
Out of 2021 eligible HIV-infected persons, 63.5% were males and 68.2% were in the age group of 26-45 years. The prevalence of TB was 17.8%. Among 360 patients with TB, 102 (28%) had smear positive TB, 86 (24%) had smear-negative TB, and 172 (48%) were diagnosed as extrapulmonary TB. Two hundred and thirty-eight (27%) TB patients with CD4+ T-Cell count below 200 compared to 122 (11%) patients above 200.
A high prevalence of TB was found among newly diagnosed HIV-infected adults attending ART center for care and treatment. The prevalence of pulmonary and extrapulmonary TB was almost equal. Chances of TB disease were more with depletion of CD4 counts. The study highlights urgent need of intensive case finding as well as periodic screening of newly diagnosed HIV-infected individuals.
结核病是人类免疫缺陷病毒（HIV）/艾滋病患者中首要的机会性感染及主要死因。当然，结核病在普通人群和HIV感染者中的患病率预计会有所不同。本研究旨在确定在印度古吉拉特邦接受抗逆转录病毒治疗（ART）中心治疗的新诊断HIV感染成人中结核病的患病率。
对2012年7月至2012年9月在ART中心接受治疗的新诊断HIV感染者进行横断面研究。对同意参与的患者进行结核病症状筛查和胸部X光检查。对所有疑似结核病病例及诊断为肺结核的患者采集痰标本，采用萋尼氏法进行显微镜检查、培养及药敏试验。采集血标本检测CD4+T细胞计数和血红蛋白。
在2021名符合条件的HIV感染者中，63.5%为男性，68.2%年龄在26 - 45岁之间。结核病患病率为17.8%。在360例结核病患者中，102例（28%）痰涂片阳性，86例（24%）痰涂片阴性，172例（48%）诊断为肺外结核。238例（27%）结核病患者CD4+T细胞计数低于200，而CD4+T细胞计数高于200的患者有122例（11%）。
在前往ART中心接受治疗的新诊断HIV感染成人中发现结核病患病率较高。肺结核和肺外结核的患病率几乎相等。CD4细胞计数减少时患结核病的几率更高。该研究凸显了迫切需要加强病例发现以及对新诊断HIV感染者进行定期筛查。
